Q: I've been seeing a physiotherapist (PT) for a problem with my low back. There's a PT student who treated me one day when my regular therapist was out sick. She did a manipulation on my back that really helped. Should I ask my regular therapist to do this, too?

A: Physiotherapists use mobilization (nonthrust joint movement) and manipulation (thrust movement) to treat joint problems including joints of the spine. These two methods of treatment are called manual therapy.

Research has shown that spinal manipulation works well for many patients with acute low back pain (LBP). As evidence mounts for this treatment method, more and more PT schools are including manual therapy as a core course of training. Therapists who graduated years ago may have learned this skill at a continuing education course. Not all therapists have manual therapy training.

Let your therapist know the results you had with the alternate treatment and your interest in trying this method again. The goal is always to improve patient function. Your therapist will be interested in knowing about anything that will help you reach your goal.

Timothy W. Flynn, PhD, OCS, FAAOMPT, et al. Spinal Manipulation in Physiotherapist Professional Degree Education: A Model for Teaching and Integration into Clinical Practice. In Journal of Orthopaedic & Sports Physiotherapy. August 2006. Vol. 36. No. 8. Pp. 577-587.